The chair of the House Ways and Means Health Subcommittee has introduced
legislation to provide financial incentives to propel the adoption of
electronic health records.
Rep. Pete Stark (D-Calif.) has introduced the Health-e Information
Technology Act of 2008 (HR 6898), which requires the government to create
standards for an interoperable health information technology system, as well
as the creation of an open-source health information technology (HIT) system
that will be made available at little or no cost to all providers. It also
provides incentives to drive the adoption of standardized, interoperable HIT
systems and includes strong, workable protections for the privacy of personal
health information.
"If we want a uniform, interoperable health care system in America,
time has shown us that we can't depend on the private sector to do it on [its]
own," Stark said. "This is the perfect role for government. We
should work with stakeholders to develop the standards, ensure an affordable
product is available, and pay providers to adopt it. That's exactly what the
Health-e Information Technology Act does."
The AMA reacted positively. "The AMA commends members of Congress,
including Chairman Stark, for recognizing the importance of moving toward an
interoperable, nationwide HIT infrastructure and for recognizing the crucial
role the federal government plays in assisting the health care industry to
accelerate the adoption and implementation of HIT systems and tools,"
said Rebecca Patchin, M.D., chair-elect of the AMA's Board of Trustees, in a
press statement.
The bill would codify the Office of the National Coordinator for Health
Information Technology (ONCHIT) within the Department of Health and Human
Services, an office created by Executive Order in 2004. In coordination with
an advisory committee representing private and public stakeholders, the
national coordinator would be responsible for creating standards to achieve
widespread adoption of interoperable, secure, and clinically useful electronic
health records. The national coordinator is Robert Kolodner, M.D., a
psychiatrist.
If the bill passes, the first generation of these standards would be
finalized no later than October 2011. In addition, to ensure availability of
an affordable system and increase choice and competition, ONCHIT would
coordinate the development of a certified open-source HIT system that meets
the standards it established. This system would be available to health care
providers at low cost as soon as possible, but no later than nine months after
the standards are set.
Physicians who install and use an approved system would be eligible for
incentive payments totaling up to approximately $40,000 over five years, while
hospitals that do the same would be eligible for incentive payments of up to
several million dollars. These incentives would phase out over a few years, at
which point Medicare payments would be reduced for those who do not use
qualified systems.